Individual
TANYA KRIESEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2150 MEMORIAL DR, GREEN BAY, WI 54303-6335
(920) 606-1868
Mailing address
1671 LENWOOD AVE APT G, GREEN BAY, WI 54303-6336
(920) 606-1868
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
5057-146
WI
Other
Enumeration date
09/27/2021
Last updated
09/27/2021
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